Method of making orthodontic appliances and of positioning teeth



April 1949- H. D. KESLING I METHOD OF MAKING ORTHODONTIC APPLIANCES ANDOF POSITIONING TEETH Original Filed July 23, 1943 JQ s.

METHDD OF MAKING ORTHODONTIC AP PLIANCES AND OF POSITIONING TEETH HaroldD. Kesling, La Porte, Ind.

Original application July 23, 1943, Serial No.

485,870. Divided and this application September 16, 1946, Serial No.697,181

6 Claims. (CI. 32-14,)

2 The present invention relates to tooth posiwill be apparent from thefollowing description tioning appliances, and is particularly concernedand the accompanying drawings, in which .simwith the provision ofimproved appliances which ilar characters of reference indicate similarparts are adapted to be used to maintain or bring the throughout theseveral views.

teeth of a user of such an appliance into a pre- Referring to the singlesheet of drawings acdetermined ideal or desirable position without thecompanying the specification:

necessity for the use of metallic bands, wires, Fig. 1 is a sideelevational view of a plaster or any of the other appliances of theprior art. model, showing the condition of the teeth of 1a The presentapplication on methods of makp t e prior t beginning of treatment; ingorthodontic appliances and methods of p0si- 1O Fig.2 is a similarmast/Breast, Showing thecontioning teeth is a division of my priorapplication dition of the rati nts teeth after a P i i a Serial No.495,870, filed July 23, 1943, on Tooth period Of treatment and Justprior to the fi l positioning appliances. step of treatment with thetooth positioning ap- In the use of the appliances oi the prior art p ia0f the invention; for orthodontia, there are certain limitations in Fi 3is another similar elevational viewof the the positioning of teeth onaccount of the intersame plaster t O Fig. 2 as it app after ference bybands or other appliances, which must teeth have, been dissected fromthe cast, [and pass between the teeth, reset upon the same base and heldby means of In attempting to position t eth ith theapwax or othersuitable material, showing the teeth pliances of the prior art, forcesare exerted on in the ideal position Which y a e fi y one or more anchorteeth, which tend to disto he Positioned; a place one or more of thganchor teeth Such de Fig. 4 is a similar elevational view ofthe samevices of the prior art are inconvenient and unplaster cast as Fig. 3, Sa at d, Wit

attractive, and are usually left on the teeth day v t e bite Opened bymeans of y Suitable form and night during the time when the teeth are ofanatomical articulator to the position of. norloeing treated. mal restforthis patient, leaving a free-wayspace One of the objects of thepresent invention is between t upper and lower e the provision of animproved tooth positioning 5 is a entary View in per ive Of device whichis adapted to effect a positioning of a tray which may b us for talkingthe teeth by means of the application of more 3 pression of both theupper and lower teeth at :the moderate force, which, nevertheless, iseffective Same e, according to the pr technique; in eventually bringingthe teeth into sub stanig. 6 is a similar viewof the tray Of 5 a tiallyideal position for the particular patient. it pp after its upp r an lwer rooves have Another object of the invention is the probeen DIOVidedth a Suita e amount of imvision of a tooth positioning appliance of thepres material d t e p ess on has been class described which is not onlyadaptable for taken, thereby forming a p te n for the final thecorrection of tooth positions that have been tooth pos ing device; dwrongly positioned for a considerable period of i is a'VieW inperspective 0f th final tooth time, but which are also adaptable for theuse positioning vi e, whi h i made of rubber or of a vast number ofusers whose teeth may be 4!) other plastic material f o -Said pattern fgradually getting out of position and by whom fiend Which is adapted fia y B h in he teeth the appliance may be used for maintaining the to theideal position of l proper position of th e t by using the device.R,eferring to Fig. 1, the plastercastof the teeth at regular intervals.of the patient shown in this figure is an illustra- Another object ofthe invention is the provision tion of teeth Which "a u in need of.or-thoof an improved technique of positioning teeth dontic treatment.This plaster cast is made in and improved apparatus by means of whichthe the usual manner, haying a p ast base lflufor technique can becarried out. the lower teeth and a similar plaster base II .for

Another object of the invention is the .prothe upper teeth. vision of animproved tooth positioning device W il t p s t t h p i nin applianceswhich is adapted to produce better results than m y e used f'ehehgihg'the position of teeth can be produced by any other knowndevices or from the position of Fig. ,1 to that :of Fig. 3 :bytechnique, and which may also be used to prevent using a multiplicity or:a plurality of diflerent mouth breathing. steps and makingintermediate-tooth"positioning "Other objects and advantages of theinvention devices, whichare :to move-the teeth only-afraction of the waytoward their final position, the example which I have selected toillustrate the invention contemplates the use of the positioning devicesof the prior art to change the position of the teeth from that of Fig. lto approximately that of Fig. 2.

The plaster casts of Figs. 2 to 4 are preferably of the type havingplane surfaces I9, 20 on the left faces of the cast so that thesesurfaces may be laid upon a table or other suitable support, with theteeth in such position as they would ordinarily assume if properlyarticulated.

The cast of Fig. 2 may be made by taking an impression in the usual wayand by making a plaster mold of the upper teeth carried by a base 2| andthe lower teeth carried by the base 22.

The model of Fig. 2 may be either a cast of teeth, the positions ofwhich are not far from the desired or proper position, or the cast ofFig. 2 may be an example of the best that can be done by way oforthodontia by means of the methods of the prior art, utilizing bands,wires, etc.

The purpose of the present invention is to produce even better resultsand to provide an appliance which can be worn at regular intervals or atsuch periods of time when the patient may be asleep or resting, or whereit may be worn in private and removed when the patient is in public.

The next step in the making of this appliance and in the technique isthat the respective teeth carried by the upper base 2| and the lowerbase 22 are dissected from these bases. This dissection may beaccomplished by means of a small scroll saw or vibrating scroll saw, asfollows: A cut may be made down between each of the teeth with the saw.The saw is then turned laterally at the base of one of these cuts, and acut may be made along the horizontal dotted lines 23, 24. This willseparate each tooth from the other teeth and from the base, and theteeth may then have their lower portions cut down to resemble thenatural root for that particular tooth. A suflicient amount of wax orother suitable material may then be placed upon each of the bases, andthe teeth may be reassembled with the bases and held in place by thewax, the wax being indicated by the numeral 25 in the spaces between thetooth roots. Each of the plaster teeth is then replaced on its properbase and in its proper position; but the position of the tooth is soaltered by the operator as to assume the ideal position for thatparticular tooth in that particular assembly, bearing in mind theformation of the jaw structure of the patient and the facial and racialcharacteristics of each patient.

The teeth are secured in place by means of wax or some other suitablematerial which is initially plastic and which has suitable qualities foradhering to the plaster.

Fig. 3 then is a plaster cast of the teeth after they have beenreassembled with their plaster bases in the ideal position in which itis desired to position the teeth.

Fig. 4 is a similar view of the same plaster cast as Fig. 3, with theteeth properly spaced for the position of normal rest for this patient,by means of a suitable articulator. Such an articulator may have thebase 2| secured to an arm l2, and base 22 secured to an arm l3. Thesearms are pivoted together at the point I4, and lower arm I3 is providedwith a suitable lower stop member l5 for engagin an adjustable rod stopmember l6 carried by the upper arm l2. The rod I6 is so adjusted by aset screw I! that the jaws of the plaster c'ast assume the ordinaryposition of rest, with a free-way or space l8 between them. Thisfree-way space l8 between the upper and lower teeth serves the purposeof the present tooth positioning appliance of allowing room forsufficient material in the appliance to secure an accurate impression ofevery tooth.

Referring now to Fig. 5, this is a view in perspective of a suitabletray, which may be used for taking the next impression of the teeth andfor providing a pattern for the making of the tooth positioningappliance.

This tray is indicated in its entirety by the numeral 30, and itcomprises a rear wall 3| and a front wall 32 joined by the transversewall 33 that passes between the teeth. The tray 30 has an upper groove:4 between the walls and a lower groove 35 between the front and rearwalls, and the size and shape of the groove varies according to thedesired shape of the finished appliance. The walls of the tray arepreferably undercut, as indicated at 36, to hold the impression materialin the tray.

The proportions of this tray are made with a view to making it thepattern for the tooth positioning appliance, which will later be worn inthe mouth; and therefore it is desirable to dispense with anyunnecessary bulk in the design of the tray.

The tray 30 is preferably made of a suitable relatively stiff materialwhich is initially plastic and which is moldable so that the tray may bemolded to correspond substantially to the arch of the teeth of thepatient without having more than a few sizes of trays. For example,there may be a number of sizes for children; but for adults, possiblylarge, medium, and small sizes of trays may be made to accommodate mostadults.

In the next step of making the appliance the upper and lower grooves ofthe tray are nearly filled with a suitable amount of impressionmaterial, and the material is disposed so that when the tray is placedbetween the teeth of the plaster cast of Fig. 4, and the articulatedteeth are brought into the position of Fig. 4, a true and accurateimpression will be made of the teeth in the position to which it isdesired to move them.

Fig. 6 is a view in perspective of such an impression and tray after theimpression has been taken, and the device of Fig. 6 serves as a patternfor the making of the tooth positioning appliance.

The next steps in the making of the appliance are the usual ones inmaking a casting, as a mold is made from the tray and impression of Fig.6; and the mold is filled with a suitable supply of resilient material,such as live rubber, which is shaped and cured in the mold to make theappliance of Fig. 7.

Fig. 7 shows the tooth positioning appliance when completed, and it is amember of live resilient molded material, having a small amount ofmaterial between all of the upper and lower teeth and havin sockets forall Of the tooth crowns, the sockets being of the proper tooth shape,but being in such position that the walls of the sockets, and theresilient material of which the whole appliance is constructed,constantly tend to move the teeth toward or into that ideal positionwhich is represented by the reconstruction of Fig. 3.

I have carried such operations to completion and have found that betterresults can be attained by means of such a tooth positioning appliancethan with any of the appliances of the prior art. and I am confirmed inmy conclusions as to the results by the observations of many otherspecialists in this profession who have observed the plaster casts of myfinished work.

The tooth positioning appliance of Fig. 7 may be worn at night by thepatient, and while he is sleeping; and it is found that in a short timethe patient will become accustomed to wearing the appliance, which alsoprevents mouth breathing, due to the fact that the mouth is closed onthe appliance during sleep. Breathing through the nose is then a matterof necessity, and the present appliance may also be used to preventundesirable breathing noises during sleeping. Other patients may wearthe appliance for a certain number of minutes or fraction of an hour ora certain number of hours at regularly stated intervals; and otherswhose teeth have been in proper position, but now appear to drift, or tobecome misaligned, may use the appliance for maintaining the properposition of their teeth by wearing it a short time each day.

While I have illustrated an appliance and described the technique forproducing only the last or final change to the desired ideal position,it will also be evident that this appliance and technique-may beemployed in a plurality of steps for moving the teeth step by step fromany extreme position to the desired and final position; but in such caseit will obviously be necessary to make a number of different appliances,each representing one step of attainment toward the final positioning ofthe teeth.

It will thus be observed that I have invented a new technique and a newapparatus for carrying out this technique, comprising a toothpositioning appliance which may be worn with less discomfort than thedevices of the prior art and which may be so constructed as to exertonly the most moderate forces upon the teeth to be positioned.

The reaction of these forces is not against one or two other teeth, asin the devices of the prior art, but against the entire denture, and thetendency of this tooth positioning appliance is to bring the teeth tothe ideal position with a minimum amount of discomfort to the wearer. Inthe application of the appliance to the teeth of the patient, it is, ofcourse, necessary to see that the teeth of the patient are actuallyseated in the recesses of the appliance when the appliance is beingworn. For this purpose it may be necessary, where the appliance isdrawing two teeth together, to stretch the appliance slightly adjacentthese two teeth as it is being applied to the teeth, while forcing theteeth into their respective sockets. In other cases, where teeth are tobe separated, it may be necessary to compress it slightly at apredetermined portion of the sockets, to bring the sockets intoalignment with the teeth on which they are to act.

The present tooth positioning device does not have the limitations as toposition of the teeth which are placed upon the operator by the use ofbands that must pass between the teeth, since this device does notrequire any parts passing between particular teeth.

The present device may be kept more sanitary than devices which arerelatively permanently attached to the teeth, as the present device maybe cleaned before and after every using. It has been found that wherethe present invention is employed, the unsightly metal wires and bandsof the conventional tooth positioning devices of the prior art may beremoved from the teeth of the patient much sooner, and the presentdevice usually produces a finished job in from four to six months.

This device eliminates a lot of dental adjustments that were previouslynecessary for the final artistic positioning of the teeth, thus reducingthe operators chair time,and the present invention also produces asuperior result.

The appliance not only permits each orthodontist to prearrange the teethfor each individual case under treatment according to the type, but italso enables the orthodontist to produce this predetermined arrangementof teeth for the patient being treated. The invention not only permitsthe orthodontist to position each tooth properly, but the form of thearch may also be predetermined and corrected.

Besides permitting the positioning of teeth and the adjustment of thearch form, the present appliance is also very efficient for theretention of the teeth in their proper form after the teeth assume thedesired position.

While I have illustrated a preferred embodiment of my invention, manymodifications may be made without departing from the spirit of theinvention, and I do not wish to be limited to the precise details ofconstruction set forth, but desire to avail myself of all changes withinthe scope of the appended claims.

Having thus described my invention, what I claim as new and desire tosecure by Letters Patent of the United States, is:

1. The method of making a tooth positioning appliance which comprisestaking an impression of the upper and lower teeth, forming a cast modelof said teeth, dissecting the teeth from said cast model, and resettingthe teeth in the desired position, and making a resilient solid memberhaving recesses shaped and located to the desired position of saidteeth.

2. The method of making a tooth positioning device, comprising taking animpression of the upper and lower teeth, with the teeth spaced apredetermined amount substantially equal to the free-way, forming a castof the teeth from said impression, dissecting predetermined teeth fromsaid cast, repositioning the dissected cast teeth on the cast in thedesired position, forming a bendable tray with a wall between the upperand lower teeth, and walls extending upwardly and downwardly and insidethe upper and lower teeth, placing a predetermined amount of impressionmaterial in the upper and lower grooves formed by the walls of saidtray, taking an impression of the re-positioned and other cast teeth inthe cast, with the upper and lower teeth spaced by the wall of the traybetween them, trimming off the excess material from said impression toform a pattern, forming a mold from said pattern, and molding aresilient tooth positioning device of live resilient material havingsockets for substantially all of the upper and lower teeth, with thesockets in the position to which it is desired to move predetermined ofsaid teeth.

3. A method of making a tooth positioner which comprises making a castmodel of the teeth of the patient in assembled relation upon upper andlower bases, dissecting predetermined teeth from said upper and lowerbases with sufficient material to form a root, forming a suitable rooton the dissected teeth, remounting the dissected teeth upon theirrespective bases in the assembly with the teeth located and positionedand oriented in the proper predetermined position for an ideal toothassembly, placing an arched tray having an upper and lower groove,

and said grooves being filled with impression material between the teethof said model, and taking an impression in said impression material ofthe teeth in the predetermined positions to which it is desired to movethem, trimming the tray and impression material to remove eXcessimpression material and form a pattern, forming a mold from saidpattern, and using said mold to form a resilient, live, stretchable, andcompressible member conforming substantially to the tray with itsimpression aftertrimming.

4. The method of making a tooth positioning appliance comprising makinga cast of the upper and lower teeth of the patient, said cast having theteeth in the natural positions corresponding to their positions in thepatients mouth, which are to be corrected, dissecting from said castpredetermined teeth and re-mounting said latter teeth on said cast inthe corrected positions to which the patients said teeth are to bemoved, and forming an integral member of resilient, stretchable anddeformable material having the cavities for the upper and lower teeth ofthe patient with the cavities for said predetermined teeth in the saidcorrected positions, so that said. member may be deformed to receive theupper and lower teeth of the patient and gripped between the teeth toimpose resiliently applied force on the teeth to orient saidpredetermined teeth in said corrected position.

5. The method of making a tooth positioning appliance which comprisestaking an impression of the teeth, forming a cast model of said teeth,displacing teeth of the cast model to positions re- 8 presenting thedesired positions of teeth in' the mouth of the user of the appliance,and making from said altered cast model a resilient solid member havingrecesses shaped and located to said desired position 'of said teeth.

6. The method of making a tooth positionin appliance which comprisestaking an impression of the teeth in positions they occupy in the mouthof the wearer of the appliance, forming a cast model of said teeth,displacing teeth of the cast model to predetermined positions displacedfrom the positions of teeth in the mouth of the user of the appliance,and making from said altered cast model a resilient solid member havingrecesses shaped and located in the displaced positions of said model sothat, when forced onto the teeth of the user, it will apply correctiveforces thereto.

HAROLD D. KESLING.

REFERENCES CITED The following references are of record in the file ofthis patent:

UNITED STATES PATENTS Number Name Date 646,629 Sugatt Apr. 3, 19001,146,264 Kelly July 13, 1915 1,302,004 Brown Apr. 29, 1919 1,518,075Kesling Dec. 2, 1924 1,691,785 Remensnyder Nov. 13, 1928 2,257,329 BrittSept. 30, 1941 2,259,160 Glaser Oct. 14, 1941 2,305,784 Harvath et alDec. 22, 1942

